Provider Demographics
NPI:1962758110
Name:HUSSAINI, SYED A (PHARM D)
Entity type:Individual
Prefix:DR
First Name:SYED
Middle Name:A
Last Name:HUSSAINI
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4207 ELBERTSON ST
Mailing Address - Street 2:6 G
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-2278
Mailing Address - Country:US
Mailing Address - Phone:347-783-4253
Mailing Address - Fax:
Practice Address - Street 1:4207 ELBERTSON ST
Practice Address - Street 2:6 G
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-2278
Practice Address - Country:US
Practice Address - Phone:347-783-4253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-25
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054351183500000X
CA58279183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist